{
"Npi": {
"NPI": "1598837619",
"EntityType": "Individual",
"ReplacementNPI": null,
"EIN": null,
"IsSoleProprietor": "Y",
"IsOrgSubpart": null,
"ParentOrgLBN": null,
"ParentOrgTIN": null,
"OrgName": null,
"LastName": "KEARNEY",
"FirstName": "ERIN",
"MiddleName": null,
"NamePrefix": null,
"NameSuffix": null,
"Credential": "P.A.-C",
"OtherOrgName": null,
"OtherOrgNameTypeCode": null,
"OtherLastName": "CONRAD",
"OtherFirstName": "ERIN",
"OtherMiddleName": "KEARNEY",
"OtherNamePrefix": null,
"OtherNameSuffix": null,
"OtherCredential": "PA-C",
"OtherLastNameTypeCode": "5",
"FirstLineMailingAddress": "3014 SEALY ST",
"SecondLineMailingAddress": "#158",
"MailingAddressCityName": "GALVESTON",
"MailingAddressStateName": "TX",
"MailingAddressPostalCode": "77550-4218",
"MailingAddressCountryCode": "US",
"MailingAddressTelephoneNumber": "409-761-6216",
"MailingAddressFaxNumber": "409-770-0298",
"FirstLinePracticeLocationAddress": "3014 SEALY ST",
"SecondLinePracticeLocationAddress": "#158",
"PracticeLocationAddressCityName": "GALVESTON",
"PracticeLocationAddressStateName": "TX",
"PracticeLocationAddressPostalCode": "77550-4218",
"PracticeLocationAddressCountryCode": "US",
"PracticeLocationAddressTelephoneNumber": "409-761-6216",
"PracticeLocationAddressFaxNumber": "409-770-0298",
"EnumerationDate": "11/14/2006",
"LastUpdateDate": "02/11/2015",
"NPIDeactivationReasonCode": null,
"NPIDeactivationReason": null,
"NPIDeactivationDate": null,
"NPIReactivationDate": null,
"GenderCode": "F",
"Gender": "Female",
"AuthorizedOfficialLastName": null,
"AuthorizedOfficialFirstName": null,
"AuthorizedOfficialMiddleName": null,
"AuthorizedOfficialTitle": null,
"AuthorizedOfficialNamePrefix": null,
"AuthorizedOfficialNameSuffix": null,
"AuthorizedOfficialCredential": null,
"AuthorizedOfficialTelephoneNumber": null,
"Taxonomies": {
"Taxonomy": {
"TaxonomyCode": "363AM0700X",
"TaxonomyName": "Medical Physician Assistant",
"LicenseNumber": "PA05088",
"LicenseNumberStateCode": "TX",
"PrimaryTaxonomySwitch": "Y"
}
},
"HealthcareProviderTaxonomyGroups": null
}
}